Comparison of single and boosted protease inhibitor versus nonnucleoside reverse transcriptase inhibitor-containing cART regimens in antiretroviral-naïve patients starting cART after January 1, 2000

A. Mocroft, A. Horban, N. Clumeck, H. J. Stellbrink, A. d'Arminio Monforte, K. Zilmer, O. Kirk, J. Gatell, A. N. Phillips, J. D. Lundgren, M. Losso, A. Duran, N. Vetter, I. Karpov, A. Vassilenko, S. De Wit, B. Poll, R. Colebunders, L. Machala, H. RozsypalD. Sedlacek, J. Nielsen, T. Benfield, J. Gerstoft, T. Katzenstein, A. B E Hansen, P. Skinhøj, C. Pedersen, C. Katlama, J. P. Viard, P. M. Girard, T. Saint-Marc, P. Vanhems, C. Pradier, F. Dabis, M. Dietrich, C. Manegold, L. van Lunzen, S. Staszewski, M. Bickel, J. W. Goethe, F. D. Goebel, G. Fätkenheuer, J. Rockstroh, R. Schmidt, J. Kosmidis, P. Gargalianos, G. Xylomenos, J. Perdios, G. Panos, A. Filandras, E. Karabatsaki, D. Bánhegyi, F. Mulcahy, I. Yust, D. Turner, M. Burke, S. Pollack, G. Hassoun, Z. Sthoeger, S. Maayan, A. Chiesi, R. Esposito, R. Borghi, C. Arici, R. Pristera, F. Mazzotta, A. Gabbuti, V. Vullo, M. Lichtnet, A. Chirianni, E. Montesarchio, G. Antonucci, F. Iacomi, P. Narciso, M. Zaccarelli, A. Lazzarin, R. Finazzi, L. Viksna, S. Chaplinskas, R. Hemmer, T. Staub, P. Reiss, J. Bruun, A. Maeland, V. Ormaasen, B. Knysz, J. Gasiorowski, D. Prokopowicz, A. Wiercinska-Drapalo, A. Boron-Kaczmarska, M. Pynka, M. Beniowski, E. Mularska, H. Trocha, F. Antunes, E. Valadas, K. Mansinho, F. Matez

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

Background: Few published studies have considered both the short- and long-term virologic or immunologic response to combination antiretroviral therapy (cART) and the impact of different cART strategies. Purpose: To compare time to initial virologic (200/mm3 cell increase) response in antiretroviral-naïve patients starting either a single protease inhibitor (PI; n = 183), a ritonavir-boosted PI regimen (n = 197), or a nonnucleoside reverse transcriptase inhibitor (NNRTI)-based cART regimen (n = 447) after January 1, 2000, and the odds of lack of virologic or immunologic response at 3 years after starting cART. Method: Cox proportional hazards models and logistic regression. Results: After adjustment, compared to patients taking an NNRTI-regimen, patients taking a single-PI regimen were significantly less likely to achieve a viral load (VL) 200/mm3 CD4 cell increase after starting cART (p > .3). At 3 years after starting cART, patients taking a single-PI-based regimen were more likely to not have virologic suppression (200/mm3 increase; p > .15). This model was adjusted for CD4 and VL at starting cART, age, prior AIDS diagnosis, year of starting cART, and region of Europe. Conclusion: Compared to patients starting an NNRTI-based regimen, patients starting a single-PI regimen were less likely to be virologically suppressed at 3 years after starting cART. These results should be interpreted with caution, because of the potential biases associated with observational studies. Ultimately, clinical outcomes, such as new AIDS diagnoses or deaths, will be the measure of efficacy of cART regimens, which requires the follow-up of a very large number of patients over many years.

Original languageEnglish
Pages (from-to)271-284
Number of pages14
JournalHIV Clinical Trials
Volume7
Issue number6
DOIs
Publication statusPublished - Nov 2006

Fingerprint

Reverse Transcriptase Inhibitors
Protease Inhibitors
Therapeutics
Viral Load
Acquired Immunodeficiency Syndrome
Ritonavir
Proportional Hazards Models
Observational Studies
Logistic Models

Keywords

  • Combination therapy
  • Immunologic success
  • Virologic success

ASJC Scopus subject areas

  • Virology
  • Immunology

Cite this

Comparison of single and boosted protease inhibitor versus nonnucleoside reverse transcriptase inhibitor-containing cART regimens in antiretroviral-naïve patients starting cART after January 1, 2000. / Mocroft, A.; Horban, A.; Clumeck, N.; Stellbrink, H. J.; d'Arminio Monforte, A.; Zilmer, K.; Kirk, O.; Gatell, J.; Phillips, A. N.; Lundgren, J. D.; Losso, M.; Duran, A.; Vetter, N.; Karpov, I.; Vassilenko, A.; De Wit, S.; Poll, B.; Colebunders, R.; Machala, L.; Rozsypal, H.; Sedlacek, D.; Nielsen, J.; Benfield, T.; Gerstoft, J.; Katzenstein, T.; Hansen, A. B E; Skinhøj, P.; Pedersen, C.; Katlama, C.; Viard, J. P.; Girard, P. M.; Saint-Marc, T.; Vanhems, P.; Pradier, C.; Dabis, F.; Dietrich, M.; Manegold, C.; van Lunzen, L.; Staszewski, S.; Bickel, M.; Goethe, J. W.; Goebel, F. D.; Fätkenheuer, G.; Rockstroh, J.; Schmidt, R.; Kosmidis, J.; Gargalianos, P.; Xylomenos, G.; Perdios, J.; Panos, G.; Filandras, A.; Karabatsaki, E.; Bánhegyi, D.; Mulcahy, F.; Yust, I.; Turner, D.; Burke, M.; Pollack, S.; Hassoun, G.; Sthoeger, Z.; Maayan, S.; Chiesi, A.; Esposito, R.; Borghi, R.; Arici, C.; Pristera, R.; Mazzotta, F.; Gabbuti, A.; Vullo, V.; Lichtnet, M.; Chirianni, A.; Montesarchio, E.; Antonucci, G.; Iacomi, F.; Narciso, P.; Zaccarelli, M.; Lazzarin, A.; Finazzi, R.; Viksna, L.; Chaplinskas, S.; Hemmer, R.; Staub, T.; Reiss, P.; Bruun, J.; Maeland, A.; Ormaasen, V.; Knysz, B.; Gasiorowski, J.; Prokopowicz, D.; Wiercinska-Drapalo, A.; Boron-Kaczmarska, A.; Pynka, M.; Beniowski, M.; Mularska, E.; Trocha, H.; Antunes, F.; Valadas, E.; Mansinho, K.; Matez, F.

In: HIV Clinical Trials, Vol. 7, No. 6, 11.2006, p. 271-284.

Research output: Contribution to journalArticle

Mocroft, A, Horban, A, Clumeck, N, Stellbrink, HJ, d'Arminio Monforte, A, Zilmer, K, Kirk, O, Gatell, J, Phillips, AN, Lundgren, JD, Losso, M, Duran, A, Vetter, N, Karpov, I, Vassilenko, A, De Wit, S, Poll, B, Colebunders, R, Machala, L, Rozsypal, H, Sedlacek, D, Nielsen, J, Benfield, T, Gerstoft, J, Katzenstein, T, Hansen, ABE, Skinhøj, P, Pedersen, C, Katlama, C, Viard, JP, Girard, PM, Saint-Marc, T, Vanhems, P, Pradier, C, Dabis, F, Dietrich, M, Manegold, C, van Lunzen, L, Staszewski, S, Bickel, M, Goethe, JW, Goebel, FD, Fätkenheuer, G, Rockstroh, J, Schmidt, R, Kosmidis, J, Gargalianos, P, Xylomenos, G, Perdios, J, Panos, G, Filandras, A, Karabatsaki, E, Bánhegyi, D, Mulcahy, F, Yust, I, Turner, D, Burke, M, Pollack, S, Hassoun, G, Sthoeger, Z, Maayan, S, Chiesi, A, Esposito, R, Borghi, R, Arici, C, Pristera, R, Mazzotta, F, Gabbuti, A, Vullo, V, Lichtnet, M, Chirianni, A, Montesarchio, E, Antonucci, G, Iacomi, F, Narciso, P, Zaccarelli, M, Lazzarin, A, Finazzi, R, Viksna, L, Chaplinskas, S, Hemmer, R, Staub, T, Reiss, P, Bruun, J, Maeland, A, Ormaasen, V, Knysz, B, Gasiorowski, J, Prokopowicz, D, Wiercinska-Drapalo, A, Boron-Kaczmarska, A, Pynka, M, Beniowski, M, Mularska, E, Trocha, H, Antunes, F, Valadas, E, Mansinho, K & Matez, F 2006, 'Comparison of single and boosted protease inhibitor versus nonnucleoside reverse transcriptase inhibitor-containing cART regimens in antiretroviral-naïve patients starting cART after January 1, 2000', HIV Clinical Trials, vol. 7, no. 6, pp. 271-284. https://doi.org/10.1310/H657-L775-83J5-8654
Mocroft, A. ; Horban, A. ; Clumeck, N. ; Stellbrink, H. J. ; d'Arminio Monforte, A. ; Zilmer, K. ; Kirk, O. ; Gatell, J. ; Phillips, A. N. ; Lundgren, J. D. ; Losso, M. ; Duran, A. ; Vetter, N. ; Karpov, I. ; Vassilenko, A. ; De Wit, S. ; Poll, B. ; Colebunders, R. ; Machala, L. ; Rozsypal, H. ; Sedlacek, D. ; Nielsen, J. ; Benfield, T. ; Gerstoft, J. ; Katzenstein, T. ; Hansen, A. B E ; Skinhøj, P. ; Pedersen, C. ; Katlama, C. ; Viard, J. P. ; Girard, P. M. ; Saint-Marc, T. ; Vanhems, P. ; Pradier, C. ; Dabis, F. ; Dietrich, M. ; Manegold, C. ; van Lunzen, L. ; Staszewski, S. ; Bickel, M. ; Goethe, J. W. ; Goebel, F. D. ; Fätkenheuer, G. ; Rockstroh, J. ; Schmidt, R. ; Kosmidis, J. ; Gargalianos, P. ; Xylomenos, G. ; Perdios, J. ; Panos, G. ; Filandras, A. ; Karabatsaki, E. ; Bánhegyi, D. ; Mulcahy, F. ; Yust, I. ; Turner, D. ; Burke, M. ; Pollack, S. ; Hassoun, G. ; Sthoeger, Z. ; Maayan, S. ; Chiesi, A. ; Esposito, R. ; Borghi, R. ; Arici, C. ; Pristera, R. ; Mazzotta, F. ; Gabbuti, A. ; Vullo, V. ; Lichtnet, M. ; Chirianni, A. ; Montesarchio, E. ; Antonucci, G. ; Iacomi, F. ; Narciso, P. ; Zaccarelli, M. ; Lazzarin, A. ; Finazzi, R. ; Viksna, L. ; Chaplinskas, S. ; Hemmer, R. ; Staub, T. ; Reiss, P. ; Bruun, J. ; Maeland, A. ; Ormaasen, V. ; Knysz, B. ; Gasiorowski, J. ; Prokopowicz, D. ; Wiercinska-Drapalo, A. ; Boron-Kaczmarska, A. ; Pynka, M. ; Beniowski, M. ; Mularska, E. ; Trocha, H. ; Antunes, F. ; Valadas, E. ; Mansinho, K. ; Matez, F. / Comparison of single and boosted protease inhibitor versus nonnucleoside reverse transcriptase inhibitor-containing cART regimens in antiretroviral-naïve patients starting cART after January 1, 2000. In: HIV Clinical Trials. 2006 ; Vol. 7, No. 6. pp. 271-284.
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abstract = "Background: Few published studies have considered both the short- and long-term virologic or immunologic response to combination antiretroviral therapy (cART) and the impact of different cART strategies. Purpose: To compare time to initial virologic (200/mm3 cell increase) response in antiretroviral-na{\"i}ve patients starting either a single protease inhibitor (PI; n = 183), a ritonavir-boosted PI regimen (n = 197), or a nonnucleoside reverse transcriptase inhibitor (NNRTI)-based cART regimen (n = 447) after January 1, 2000, and the odds of lack of virologic or immunologic response at 3 years after starting cART. Method: Cox proportional hazards models and logistic regression. Results: After adjustment, compared to patients taking an NNRTI-regimen, patients taking a single-PI regimen were significantly less likely to achieve a viral load (VL) 200/mm3 CD4 cell increase after starting cART (p > .3). At 3 years after starting cART, patients taking a single-PI-based regimen were more likely to not have virologic suppression (200/mm3 increase; p > .15). This model was adjusted for CD4 and VL at starting cART, age, prior AIDS diagnosis, year of starting cART, and region of Europe. Conclusion: Compared to patients starting an NNRTI-based regimen, patients starting a single-PI regimen were less likely to be virologically suppressed at 3 years after starting cART. These results should be interpreted with caution, because of the potential biases associated with observational studies. Ultimately, clinical outcomes, such as new AIDS diagnoses or deaths, will be the measure of efficacy of cART regimens, which requires the follow-up of a very large number of patients over many years.",
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author = "A. Mocroft and A. Horban and N. Clumeck and Stellbrink, {H. J.} and {d'Arminio Monforte}, A. and K. Zilmer and O. Kirk and J. Gatell and Phillips, {A. N.} and Lundgren, {J. D.} and M. Losso and A. Duran and N. Vetter and I. Karpov and A. Vassilenko and {De Wit}, S. and B. Poll and R. Colebunders and L. Machala and H. Rozsypal and D. Sedlacek and J. Nielsen and T. Benfield and J. Gerstoft and T. Katzenstein and Hansen, {A. B E} and P. Skinh{\o}j and C. Pedersen and C. Katlama and Viard, {J. P.} and Girard, {P. M.} and T. Saint-Marc and P. Vanhems and C. Pradier and F. Dabis and M. Dietrich and C. Manegold and {van Lunzen}, L. and S. Staszewski and M. Bickel and Goethe, {J. W.} and Goebel, {F. D.} and G. F{\"a}tkenheuer and J. Rockstroh and R. Schmidt and J. Kosmidis and P. Gargalianos and G. Xylomenos and J. Perdios and G. Panos and A. Filandras and E. Karabatsaki and D. B{\'a}nhegyi and F. Mulcahy and I. Yust and D. Turner and M. Burke and S. Pollack and G. Hassoun and Z. Sthoeger and S. Maayan and A. Chiesi and R. Esposito and R. Borghi and C. Arici and R. Pristera and F. Mazzotta and A. Gabbuti and V. Vullo and M. Lichtnet and A. Chirianni and E. Montesarchio and G. Antonucci and F. Iacomi and P. Narciso and M. Zaccarelli and A. Lazzarin and R. Finazzi and L. Viksna and S. Chaplinskas and R. Hemmer and T. Staub and P. Reiss and J. Bruun and A. Maeland and V. Ormaasen and B. Knysz and J. Gasiorowski and D. Prokopowicz and A. Wiercinska-Drapalo and A. Boron-Kaczmarska and M. Pynka and M. Beniowski and E. Mularska and H. Trocha and F. Antunes and E. Valadas and K. Mansinho and F. Matez",
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month = "11",
doi = "10.1310/H657-L775-83J5-8654",
language = "English",
volume = "7",
pages = "271--284",
journal = "HIV Clinical Trials",
issn = "1528-4336",
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TY - JOUR

T1 - Comparison of single and boosted protease inhibitor versus nonnucleoside reverse transcriptase inhibitor-containing cART regimens in antiretroviral-naïve patients starting cART after January 1, 2000

AU - Mocroft, A.

AU - Horban, A.

AU - Clumeck, N.

AU - Stellbrink, H. J.

AU - d'Arminio Monforte, A.

AU - Zilmer, K.

AU - Kirk, O.

AU - Gatell, J.

AU - Phillips, A. N.

AU - Lundgren, J. D.

AU - Losso, M.

AU - Duran, A.

AU - Vetter, N.

AU - Karpov, I.

AU - Vassilenko, A.

AU - De Wit, S.

AU - Poll, B.

AU - Colebunders, R.

AU - Machala, L.

AU - Rozsypal, H.

AU - Sedlacek, D.

AU - Nielsen, J.

AU - Benfield, T.

AU - Gerstoft, J.

AU - Katzenstein, T.

AU - Hansen, A. B E

AU - Skinhøj, P.

AU - Pedersen, C.

AU - Katlama, C.

AU - Viard, J. P.

AU - Girard, P. M.

AU - Saint-Marc, T.

AU - Vanhems, P.

AU - Pradier, C.

AU - Dabis, F.

AU - Dietrich, M.

AU - Manegold, C.

AU - van Lunzen, L.

AU - Staszewski, S.

AU - Bickel, M.

AU - Goethe, J. W.

AU - Goebel, F. D.

AU - Fätkenheuer, G.

AU - Rockstroh, J.

AU - Schmidt, R.

AU - Kosmidis, J.

AU - Gargalianos, P.

AU - Xylomenos, G.

AU - Perdios, J.

AU - Panos, G.

AU - Filandras, A.

AU - Karabatsaki, E.

AU - Bánhegyi, D.

AU - Mulcahy, F.

AU - Yust, I.

AU - Turner, D.

AU - Burke, M.

AU - Pollack, S.

AU - Hassoun, G.

AU - Sthoeger, Z.

AU - Maayan, S.

AU - Chiesi, A.

AU - Esposito, R.

AU - Borghi, R.

AU - Arici, C.

AU - Pristera, R.

AU - Mazzotta, F.

AU - Gabbuti, A.

AU - Vullo, V.

AU - Lichtnet, M.

AU - Chirianni, A.

AU - Montesarchio, E.

AU - Antonucci, G.

AU - Iacomi, F.

AU - Narciso, P.

AU - Zaccarelli, M.

AU - Lazzarin, A.

AU - Finazzi, R.

AU - Viksna, L.

AU - Chaplinskas, S.

AU - Hemmer, R.

AU - Staub, T.

AU - Reiss, P.

AU - Bruun, J.

AU - Maeland, A.

AU - Ormaasen, V.

AU - Knysz, B.

AU - Gasiorowski, J.

AU - Prokopowicz, D.

AU - Wiercinska-Drapalo, A.

AU - Boron-Kaczmarska, A.

AU - Pynka, M.

AU - Beniowski, M.

AU - Mularska, E.

AU - Trocha, H.

AU - Antunes, F.

AU - Valadas, E.

AU - Mansinho, K.

AU - Matez, F.

PY - 2006/11

Y1 - 2006/11

N2 - Background: Few published studies have considered both the short- and long-term virologic or immunologic response to combination antiretroviral therapy (cART) and the impact of different cART strategies. Purpose: To compare time to initial virologic (200/mm3 cell increase) response in antiretroviral-naïve patients starting either a single protease inhibitor (PI; n = 183), a ritonavir-boosted PI regimen (n = 197), or a nonnucleoside reverse transcriptase inhibitor (NNRTI)-based cART regimen (n = 447) after January 1, 2000, and the odds of lack of virologic or immunologic response at 3 years after starting cART. Method: Cox proportional hazards models and logistic regression. Results: After adjustment, compared to patients taking an NNRTI-regimen, patients taking a single-PI regimen were significantly less likely to achieve a viral load (VL) 200/mm3 CD4 cell increase after starting cART (p > .3). At 3 years after starting cART, patients taking a single-PI-based regimen were more likely to not have virologic suppression (200/mm3 increase; p > .15). This model was adjusted for CD4 and VL at starting cART, age, prior AIDS diagnosis, year of starting cART, and region of Europe. Conclusion: Compared to patients starting an NNRTI-based regimen, patients starting a single-PI regimen were less likely to be virologically suppressed at 3 years after starting cART. These results should be interpreted with caution, because of the potential biases associated with observational studies. Ultimately, clinical outcomes, such as new AIDS diagnoses or deaths, will be the measure of efficacy of cART regimens, which requires the follow-up of a very large number of patients over many years.

AB - Background: Few published studies have considered both the short- and long-term virologic or immunologic response to combination antiretroviral therapy (cART) and the impact of different cART strategies. Purpose: To compare time to initial virologic (200/mm3 cell increase) response in antiretroviral-naïve patients starting either a single protease inhibitor (PI; n = 183), a ritonavir-boosted PI regimen (n = 197), or a nonnucleoside reverse transcriptase inhibitor (NNRTI)-based cART regimen (n = 447) after January 1, 2000, and the odds of lack of virologic or immunologic response at 3 years after starting cART. Method: Cox proportional hazards models and logistic regression. Results: After adjustment, compared to patients taking an NNRTI-regimen, patients taking a single-PI regimen were significantly less likely to achieve a viral load (VL) 200/mm3 CD4 cell increase after starting cART (p > .3). At 3 years after starting cART, patients taking a single-PI-based regimen were more likely to not have virologic suppression (200/mm3 increase; p > .15). This model was adjusted for CD4 and VL at starting cART, age, prior AIDS diagnosis, year of starting cART, and region of Europe. Conclusion: Compared to patients starting an NNRTI-based regimen, patients starting a single-PI regimen were less likely to be virologically suppressed at 3 years after starting cART. These results should be interpreted with caution, because of the potential biases associated with observational studies. Ultimately, clinical outcomes, such as new AIDS diagnoses or deaths, will be the measure of efficacy of cART regimens, which requires the follow-up of a very large number of patients over many years.

KW - Combination therapy

KW - Immunologic success

KW - Virologic success

UR - http://www.scopus.com/inward/record.url?scp=33846531821&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=33846531821&partnerID=8YFLogxK

U2 - 10.1310/H657-L775-83J5-8654

DO - 10.1310/H657-L775-83J5-8654

M3 - Article

C2 - 17208897

AN - SCOPUS:33846531821

VL - 7

SP - 271

EP - 284

JO - HIV Clinical Trials

JF - HIV Clinical Trials

SN - 1528-4336

IS - 6

ER -